Disc pathologies Part One

   

I often have patients come into my office for treatment of low back pain telling me that in the past they have been told they have a slipped disc, a bulging disc or a herniated disc. They often can’t remember which one exactly and I can’t blame them because even in healthcare people often use the terms interchangeably. First the most important thing to remember is a MRI is needed to truly diagnose disc pathologies. I will try and explain the difference between a bulge, herniation and the ever elusive slipped disc. Because of the amount of information involved I will break this topic into several parts. First we need to go over a little basic anatomy. The normal spine consists of 24 bones or vertebra and in between those vertebra are structures that cushion the everyday compressive forces put on our spine, these are your intervertebral discs. The discs are made up of a fibrous outer ring and a gelatinous inner substance. At the level of these discs are the



nerves that come off of the spinal cord and go throughout your body. When there is damage to your disc due to trauma, repetitive motion or normal aging you can have a condition where the disc becomes unstable and the inner disc material can actually leak out through the outer ring. When this happens the disc material can cause irritation to the surrounding nerve or even cause nerve compression. A disc bulge is when you have an extension of disc tissue past the border that is greater than 50 percent of the disc and extends less than 3 mm. This can be a normal variant (usually at L5-S1) due to disc degeneration. A lot of times people can have disc bulges with no symptoms.



 A herniation is localized (less than 50 percent of disc circumference) displacement of disc material beyond the normal margins of the disc space and can be contained (covered by the annular fibers) or uncontained. A herniation can be broad based (25-50 percent of the circumference) or focal (less than 25 percent).  There is almost always pain associated with herniations.


  I hope this helps to explain the basic difference between a disc bulge and a disc herniation. I will  soon post a part two and will talk more about the different types of disc herniations, the typical symptoms that people can have with any of these conditions and types of treatment available. And I promise I'll talk about a slipped disc. If you are looking for a chiropractor in Campbell County or if you have any questions regarding the topic of this post please feel free to call Alexandria Chiropractic Center at 859-635-6666 and ask to speak with Dr. Crowley.